A Continuing Partnership: Dr. Eric Sandler Reflects

We are now out in the countryside and I wanted to take a few moments to reflect on our last few days at the National Center for Maternal and Child Health. We spent our afternoons giving lectures with our wonderful translators and our slides translated into Mongolian for the audience. This proved to be rewarding and exhausting. In the mornings, I continued to see patients in the Hematology/Oncology unit with a wide variety of hematologic and oncologic disorders. The staff seemed starved for new information- which likely comes from the fact that the most current literature is in English and few of the staff speak or read in English. This must prove very difficult for keeping up with current practices and treatment. I strongly encouraged the new doctors- residents and fellows- to think through a differential and use their available resources before jumping to a conclusion as to diagnosis.

We discussed the problem of iron overload and the need to chelate patients on chronic transfusion, which they do not routinely do. I was also struck by the number of patients with Hepatitis C despite the fact that “the national blood center has been “screening” all donors for the last 3 years. When we met with the hospital director, he too was surprised by this and will plan a formal study of this problem. The new cancer center building will be opening early next year and the plan is to have all children with cancer and blood disorders treated at the Children’s Hospital. Because they have not seen many of the solid tumor patients- they are a little apprehensive about now having to treat these patients. Dr. Chimgee has a plan in place to phase in the other patients by diagnosis and asked for help with treatment roadmaps. I believe that this will bring a new level to our collaborative efforts and I can’t wait to see the results next year.

So for now, we say farewell to our Mongolian friends and colleagues but look forward to an ongoing relationship!